Occupational therapy is the health profession that helps people regain and build skills that are important for daily life, such as play and learning. Children with autism often have trouble with these skills, which can cause problems in other areas of their lives. A comprehensive occupational therapy evaluation can identify these deficits, provide information about how they might be addressed and help develop a treatment plan.
The purpose of this study was to evaluate occupational functioning in inpatients and recently discharged patients with schizophrenia and assess the relationship of occupational functioning to demographic, clinical and cognitive measures. Thirty-five inpatients and 29 recently discharged outpatients with schizophrenia were evaluated by trained clinicians using the comprehensive occupational therapy evaluation COTE scale, the Positive and Negative Syndrome Scale PANSS, and a neuropsychological battery that included the Wisconsin Card Sorting Test WCST, the Continuous Perfomance Test CPT, the digit symbol coding subtest from the Wechsler Adult Intelligence Scale Parts A and B TMT-A, TMT-B and the Trail Making Task.
Results from the COTE and PANSS ratings were correlated with occupational functioning and a variety of demographic, clinical and cognitive measures using Spearman correlation coefficients. All but one of the three COTE dimensional scores were significantly correlated with the PANSS negative and positive symptom scores. The COTE general behavior and interpersonal communication and task behavior scores were also significantly correlated with the severity of psychiatric symptoms. In addition, the WCST measure of errors and omissions and the CPT total time to complete the trial were correlated with occupational functioning.
The relationships identified in this study support the hypothesis that occupational functioning is related to the severity of psychiatric symptoms and to demographic, clinical and cognitive factors. Future studies should evaluate occupational functioning independently from evaluations of clinical symptoms and cognitive function to avoid overlapping and confounding ratings. Further, these studies should follow patients over time to clarify whether it is the case that poor occupatonal skills magnify negative symptoms or vice versa.
A comprehensive occupational therapy evaluation is a systematic process conducted by occupational therapists to assess an individual’s functional abilities, limitations, and needs related to daily activities, also known as occupations. This evaluation is fundamental in developing personalized intervention plans to help individuals achieve their goals and maximize their independence in various life domains.
The components of a comprehensive occupational therapy evaluation typically include:
Client Interview: Occupational therapists engage in conversations with the individual and, if appropriate, their caregivers or family members to gather information about the individual’s medical history, current concerns, goals, and preferences related to daily activities.
Occupational Profile: Therapists gather information about the individual’s roles, routines, and activities of daily living ADLs such as self-care, work, leisure, and social participation. Understanding the individual’s lifestyle and context helps therapists tailor interventions to meet their specific needs and priorities.
Assessment of Functional Skills: Occupational therapists assess the individual’s ability to perform various functional tasks and activities relevant to their daily life. This may include tasks such as dressing, grooming, bathing, meal preparation, household management, community mobility, and vocational activities.
Cognitive and Perceptual Assessment: Occupational therapists evaluate cognitive functions such as memory, attention, problem-solving, and executive functioning, as well as perceptual skills such as visual perception and spatial awareness. These assessments help identify cognitive and perceptual barriers that may impact the individual’s ability to engage in meaningful activities.
Assessment of Sensory Processing: Occupational therapists assess how the individual processes and responds to sensory stimuli (e.g., touch, movement, sight, sound) in their environment. Sensory processing difficulties can affect a person’s ability to participate in daily activities and may require targeted intervention strategies.